David Cameron faced embarrassment after Tory activists produced leaflets making lurid predictions about the scale of immigration to Britain and claiming that newcomers jumped hospital waiting-lists.

They were distributed in the same West Midlands borough where the Conservative parliamentary candidate Nigel Hastilow was forced to resign after insisting that Enoch Powell was right on immigration.

Labour said the language used proved that grassroots members continued to whip up hostility to immigrants in defiance of Mr Cameron’s promises to root out racist attitudes.

The newsletter, which was sent out in Dudley, details how the Government had “lost all control of immigration and asylum”.

It cites a forecast by Migrationwatch, the right-wing thinktank, which claims 7.2 million immigrants will come to Britain in the next 20 years.

Under the headline “NHS queue jumping” it quotes a newspaper report that patients who cannot speak English are sent to the front of the outpatients queue, meaning that at busy times English speakers are “shunted back”.

It also recalls the recent disclosure that four asylum seekers smuggled themselves into Britain in a lorry delivering a new car to Tony Blair, the former Prime Minister.

It adds the warning: “If you go abroad on holiday, check your suitcases before you come back!”

The newsletter, which includes Mr Cameron’s signature, also sets out the stall of John Perry, the party’s prospective parliamentary candidate in Dudley North.

It says: “Labour have let two million people enter this country – more pressure on the NHS and schools, more houses to be built for people who have never paid a penny in tax. We say: Put Britain First!”

The leaflet was produced from an office in Halesowen. The telephone at the address was out of order last night.

The party’s national headquarters was unable to say whether the publisher, Kerry-Lea Jiggens, was a Tory employee.

The address was also the office of Mr Hastilow, who stood down as the candidate for Halesowen and Rowley Regis after refusing to apologise for his remarks about Enoch Powell.

Last night a Tory spokesman rebuked the activists over the leaflet’s wording.

He said: “Everyone should take great care when discussing what can be a sensitive and even inflammatory issue. Britain benefits from immigration, but immigration should be controlled.”

But Peter Hain, the Work and Pensions Secretary, said: “This is yet another example of the racist underbelly of the Conservative Party.

“David Cameron preaches change but he hasn't delivered it.

“Indeed, far from condemning this and taking action, David Cameron has remained silent and allowed his signature to be put on this type of literature.

“No one should be under any doubt that the grassroots of the Conservative Party remain very nasty.”

Mr Hastilow said yesterday the difference between him and his party were “only a few words, and I admit they are very loaded words, which are 'Enoch Powell'”.

He told the radio station Talk Sport: “I was trying not to be in any way racist about the question of immigration.”